EP0168604A1 - Support pour transducteurs en forme de veste - Google Patents

Support pour transducteurs en forme de veste Download PDF

Info

Publication number
EP0168604A1
EP0168604A1 EP85106697A EP85106697A EP0168604A1 EP 0168604 A1 EP0168604 A1 EP 0168604A1 EP 85106697 A EP85106697 A EP 85106697A EP 85106697 A EP85106697 A EP 85106697A EP 0168604 A1 EP0168604 A1 EP 0168604A1
Authority
EP
European Patent Office
Prior art keywords
vest
torso
instrumentation
sheet
heart
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
EP85106697A
Other languages
German (de)
English (en)
Other versions
EP0168604B1 (fr
Inventor
Richard H. Moore
H. William. Strauss
Nathaniel M. Alpert
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
General Hospital Corp
Original Assignee
General Hospital Corp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by General Hospital Corp filed Critical General Hospital Corp
Priority to AT85106697T priority Critical patent/ATE45280T1/de
Publication of EP0168604A1 publication Critical patent/EP0168604A1/fr
Application granted granted Critical
Publication of EP0168604B1 publication Critical patent/EP0168604B1/fr
Expired legal-status Critical Current

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/68Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6801Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
    • A61B5/6802Sensor mounted on worn items
    • A61B5/6804Garments; Clothes
    • A61B5/6805Vests
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/02Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/026Measuring blood flow
    • A61B5/0275Measuring blood flow using tracers, e.g. dye dilution
    • A61B5/02755Radioactive tracers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/24Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/24Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/25Bioelectric electrodes therefor
    • A61B5/279Bioelectric electrodes therefor specially adapted for particular uses
    • A61B5/28Bioelectric electrodes therefor specially adapted for particular uses for electrocardiography [ECG]
    • A61B5/282Holders for multiple electrodes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A61B6/42Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment with arrangements for detecting radiation specially adapted for radiation diagnosis
    • A61B6/4208Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment with arrangements for detecting radiation specially adapted for radiation diagnosis characterised by using a particular type of detector
    • A61B6/4258Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment with arrangements for detecting radiation specially adapted for radiation diagnosis characterised by using a particular type of detector for detecting non x-ray radiation, e.g. gamma radiation
    • GPHYSICS
    • G01MEASURING; TESTING
    • G01TMEASUREMENT OF NUCLEAR OR X-RADIATION
    • G01T1/00Measuring X-radiation, gamma radiation, corpuscular radiation, or cosmic radiation
    • G01T1/16Measuring radiation intensity
    • G01T1/161Applications in the field of nuclear medicine, e.g. in vivo counting

Definitions

  • a portable system capable of being easily placed about the human torso so as to permit a subject under investigation to be monitored in cardiac function during normal or near normal daily activity is shown in our above-identified application.
  • One parameter of interest during such studies and examinations is the cardiac ejection fraction or the relative volume of fluid pumped by the heart on each beat. This can be accomplished by applying a radioactive substance to the subject's blood so that it circulates through the heart, ultimately appearing in the left ventricle. A 'detector of the radioactive emissions is placed proximate to the heart and senses the level of radioactive decay. Since this is a function of the volume of blood in the left ventricle, the ejection fraction can be determined from the variations in the detected radioactivity over a heart beat cycle.
  • the present invention provides a vest adapted to be worn about the torso of a human or animal subject being monitored in heart or other organ function or being administered medication or therapy during ambulatory activities.
  • the vest positions a detector for heart activity, such as a radioactivity detector, in a location relative to the heart tbat-is kept constant during routine or even stressful activities of the subject.
  • the vest typically comprises a sheet of a low density, thermally formable plastic.
  • the sheet is readily thermally formable to an approximate torso contour and can bend or flex to permit it to adjust to the torso of the subject. Strapping secures the sheet in this position allowing body motion, but restricting the motion of the front of the vest relative to the subject's torso.
  • a detector for radioactivity is positioned and secured to the sheet at a location which places it over the subject's heart. The security of positioning of the vest insures that the motions the subject executes will not result in a variation of detector output attributable to those motions.
  • High voltage energizing circuitry for the detector is furthermore located in the detector assembly or on the vest proximate to the detector, eliminating lengthy and dangerous high voltage leads.
  • Detectors for other than heart function monitoring may be utilized including sonic or ultra sound, plethysmograph, temperature, ECG, EMG, skin resistance and wetness, or thermal loss.
  • an array of detectors may be utilized and affixed to the vest.
  • the vest further permits fixed placement of broadcast and receiving units on opposite sides of body organs to be monitored, such as the use of microwave emitters and receivers, typically in arrays, to detect dielectric constants.
  • the vest may itself be instrumented with strain gages or elastic elongation detectors to cause the vest to act as a transducer for heart beat detection, blood pressure or tidal lung volume measurement.
  • the vest will also function as a stable platform for instrumentation used to administer medications, as through infusion apparatus, or therapy, such as radiant heat, light or nuclear particles.
  • the sheet material forming the vest is typically dimensioned to extend vertically (or horizontally with animals) from a point just below the subject's neck to a point above the hips. Horizontally, the sheet is preformed thermally to wrap around the torso from the back of the subject, under one arm, across the breast, under the other arm to the back. Strapping secures the back ends together and loops over the shoulders, supporting the vest from the shoulders.
  • adhesive-backed thin padding is applied over the edges of the sheet and other chafe points as needed to prevent abrasion.
  • a petroleum jelly lubricant is applied at potential abrasion sites where padding alone is inadequate.
  • the sheet is preferably apertured to promote ventilation of the torso, allowing heat to exhaust, providing instrument mounting sites, and aiding vest flexing and formability.
  • the present invention contemplates a vest for positioning medical instrumentation about the torso of a human or animal subject in a manner that permits most routine motions of every day living but prevents the dislocation of the instrumentation relative to the position of an organ or tissue of interest within the torso.
  • a torso 10 is seen in front view and has wrapped around it a vest 12 comprising a sheet 14.
  • the sheet 14 preferable comprises a plastic such as a low density plolyethelyne in which the molecules are expanded in curing to impart thermal preformability, flexibility, and light weight to the vest structure.
  • the sheet may also be apertured with holes 16 to further enhance formability, flexibility and reduce the weight, and to exhaust body heat for wearer comfort.
  • the sheet thus formed is dimensionally rigid but flexible in its ability to bend around and contour to the torso 10.
  • the sheet 14 is dimensioned to extend vertically from just below the neck 18 to a position above the hips 20.
  • the sheet 14 extends horizontally around the torso from the back (Fig. 2) at a first end 22, under the arm 24, being cut low to accommodate the arm pit 26.
  • the sheet then is adapted to cross the breast of the torso to pass under the other arm 28, being cut low to accommodate the other arm pit, terminating at an end 30 in the back.
  • Peripheral portions of the sheet 14 are edged or covered with a soft material 32 such as an adhesive backed thin padding to reduce abrasion of the skin of the subject during use.
  • Lubricants typically petroleum jelly, can be added between sheet and skin in use.
  • the ends 22 and 30 are held together in the rear or back portion by straps 34 and 36 which are passed through loops 38, fastened in the ends 22 and 30, and attach back upon themselves through hook and pile fasteners 40 such as VELCRO or other adjustable, releasable fasteners.
  • the straps 34 and 36 may include elastic protions 42 to permit greater subject motion within the vest 12. Alternatively, the elastic or spring elements may be incorporated into the loops 38 or their manner of attachment to the sheet 14.
  • the fasteners for the straps 34 and 36 are preferably such that they will unfasten if the subject inhales to extreme lung capacity. In any event, the strapping permits rapid removal of the fastenings and vest by attendants as may become necessary in an emergency.
  • a modification to the vest front is shown in Fig. 3.
  • a quick release strip 39 such as a hook and pile fastener, snaps, or zipper, extends vertically across the vest to permit instant vest release and removal.
  • Additional straps 44 and 46 are attached to the top front of the sheet 14 and loop over the shoulders 48 and 50, over pads 52 and 54 for comfort and protection.
  • the straps 44 and 46 proceed over the shoulders and cross each other in the back extending through hook and pile or other quick release fasteners 56 and 58 to opposite ends 30 and 22 of the sheet 14.
  • the sheet is positioned over the torso 10 to allow subject flexibility but prevent the movement of the vest 12 relative to a location 60 to be instrumented.
  • the sheet may be made available in a variety of sizes and shapes to fit all torso types.
  • the sheet may be distored by heating to provide a closer fit with typical or individual torso topography.
  • Also contributing to the fit of the vest, reducing relative motion between the torso and the vest, is a match in vest shape to the generally conical or ellipsoidal shape of the rib cage of the torso.
  • the plastic material of the sheet 14 can be thermally deformed at low temperatures such as 140o.F, to facilitate this match and other contouring.
  • the vest 12 greatly enhances the ability of the vest 12 to move with the torso and thus follow its motions, avoiding measurement or application inaccuracy.
  • the front of the vest is adapted to receive and secure by conventional means a detector module 64 for sensing radioactive emissions from blood in the heart. Holes 16 provide sites for such instrumentation attachment if desired. Typically, in the measurement of ejection fraction, the detector module 64 is placed over the left ventricle of the subject's heart. Heart position identification with a gamma camera may be useful in initial positioning of the vest relative to the heart left ventricle.
  • the detector module 64 typically has a sodium iodide crystal detector.
  • the detector module 64 includes a parallel array of cadmium telluride detectors as described in our copending application identified above, and specifically incorporated herein by reference.
  • a high voltage power supply 70 is provided for the detector and located proximate to or embodied within the detector module 64 to minimize the length of high voltage cabling between supply and detector.
  • Electronics as shown in our above identified application, is typically distributed between a hip module 72, supported about the shoulder by a strap 74, and the detector module 64.
  • Electronics 72 powers the detector module 64 and provides signal processing as shown in the above identified application. The result of such signal processing is to permit determination of ejection fraction.
  • a background detector 78 Associated with the detector module 64 is a background detector 78 which functions to monitor background radiation for normalizing the output of the main detector module 64 as noted in the above identified application.
  • Alternative detectors for which the vest is particularly -adapted include sensors for sound or ultra sound (including sectored or Doppler sensing) plethysmography, ECG, EMG, ratiographic tissue absorption characteristics, temperature distributions, skin resistance, skin wetness, and thermal loss measurement.
  • the vest 12 is well adapted to positioning such sensors in an array 80, as shown in F.ig. 4, in one or more areas of the vest.
  • the vest 12 is also adaptable to mount a broadcaster 82 and receiver 84 on opposite torso sides, and in particular to apply a radiation 86 through an organ 88 to detect organ function as by its radiation absorption.
  • an arrayed microwave emitter can be utilized opposite an arrayed microwave detector to determine organ dielectric properties from radiation absorption and re-radiation.
  • the vest will also function as a transducer itself if instrumented to detect its deflections under the pressure of heart pumping, or lung-chest expansion with respiration.
  • a strain gage or similar sensor 90 can be affixed to the vest or to the strapping as shown in Fig. 6. Its output can be calibrated using independent heart beat, blood pressure, or spirometric detection permitting subsequent ambulatory monitoring of these functions.
  • the vest additionally functions to permit the attachment of instrumentation adapted to administer medication through infusion apparatus, or to permit continuous application of a therapeutic radiation.
  • a therapeutic radiation can take the form of heat, light, or nuclear as desired.
  • the vest also readily permits combining several monitoring or administration functions simultaneously.
  • a modified vest 12a utilizing the stability imparting fastenings 34a, 36a, 52a, and 54a and contouring features noted above, is used to permit instrumentation of an animal 10a. Similar stability of instrument placement can be achieved with animals as well.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Medical Informatics (AREA)
  • Physics & Mathematics (AREA)
  • Biomedical Technology (AREA)
  • General Health & Medical Sciences (AREA)
  • Molecular Biology (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Animal Behavior & Ethology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Surgery (AREA)
  • Biophysics (AREA)
  • Pathology (AREA)
  • Optics & Photonics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • High Energy & Nuclear Physics (AREA)
  • Cardiology (AREA)
  • Physiology (AREA)
  • Hematology (AREA)
  • General Physics & Mathematics (AREA)
  • Spectroscopy & Molecular Physics (AREA)
  • Radiology & Medical Imaging (AREA)
  • Professional, Industrial, Or Sporting Protective Garments (AREA)
  • Measuring And Recording Apparatus For Diagnosis (AREA)
  • Joints Allowing Movement (AREA)
  • Finger-Pressure Massage (AREA)
  • Apparatus For Radiation Diagnosis (AREA)
  • Outer Garments And Coats (AREA)
EP85106697A 1984-06-01 1985-05-30 Support pour transducteurs en forme de veste Expired EP0168604B1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AT85106697T ATE45280T1 (de) 1984-06-01 1985-05-30 Halterung fuer sensoren in form einer weste.

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US616491 1984-06-01
US06/616,491 US4572197A (en) 1982-07-01 1984-06-01 Body hugging instrumentation vest having radioactive emission detection for ejection fraction

Publications (2)

Publication Number Publication Date
EP0168604A1 true EP0168604A1 (fr) 1986-01-22
EP0168604B1 EP0168604B1 (fr) 1989-08-09

Family

ID=24469687

Family Applications (1)

Application Number Title Priority Date Filing Date
EP85106697A Expired EP0168604B1 (fr) 1984-06-01 1985-05-30 Support pour transducteurs en forme de veste

Country Status (8)

Country Link
US (1) US4572197A (fr)
EP (1) EP0168604B1 (fr)
JP (1) JPS612843A (fr)
AT (1) ATE45280T1 (fr)
CA (1) CA1264069A (fr)
DE (1) DE3572120D1 (fr)
DK (1) DK241685A (fr)
IL (1) IL75274A (fr)

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WO2009144717A2 (fr) * 2008-05-27 2009-12-03 Volusonics Medical Imaging Ltd. Vêtement à ultrasons
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FR3001299A1 (fr) * 2013-01-23 2014-07-25 Medical Ag Dispositif de radiologie
US11268303B2 (en) 2018-03-23 2022-03-08 Neutron Holdings, Inc. Lock assembly for securing a wheeled vehicle

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GB2457025A (en) * 2008-01-30 2009-08-05 Bmr Res & Dev Ltd Garment for carrying electrotherapy electrodes
WO2009144717A2 (fr) * 2008-05-27 2009-12-03 Volusonics Medical Imaging Ltd. Vêtement à ultrasons
WO2009144717A3 (fr) * 2008-05-27 2010-01-28 Volusonics Medical Imaging Ltd. Vêtement à ultrasons
US8465433B2 (en) 2008-05-27 2013-06-18 Volusonics Medical Imaging Ltd. Ultrasound garment
GB2467555A (en) * 2009-02-04 2010-08-11 Iti Scotland Ltd A harness for an animal parturition sensor
FR3001299A1 (fr) * 2013-01-23 2014-07-25 Medical Ag Dispositif de radiologie
WO2014114555A1 (fr) * 2013-01-23 2014-07-31 Ag Medical Dispositif de radiologie
CN104969091A (zh) * 2013-01-23 2015-10-07 Ag医疗公司 放射学设备
CN104969091B (zh) * 2013-01-23 2018-02-13 Ag医疗公司 放射学设备
US11268303B2 (en) 2018-03-23 2022-03-08 Neutron Holdings, Inc. Lock assembly for securing a wheeled vehicle

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US4572197A (en) 1986-02-25
IL75274A0 (en) 1985-09-29
JPS612843A (ja) 1986-01-08
DK241685D0 (da) 1985-05-30
EP0168604B1 (fr) 1989-08-09
ATE45280T1 (de) 1989-08-15
JPH0554350B2 (fr) 1993-08-12
DE3572120D1 (en) 1989-09-14
CA1264069A (fr) 1989-12-27
IL75274A (en) 1990-08-31
DK241685A (da) 1985-12-02

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